Excludes1 pair
D13.7 vs D35-
D13.7 and D35 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on D35
benign neoplasm of endocrine pancreas (D13.7)
D13.7
Benign neoplasm of endocrine pancreas
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Islet cell tumor
- Benign neoplasm of islets of Langerhans
Indexed under
- Islet cell tumor, pancreas
- Nesidioblastoma › pancreas
- Nesidioblastoma › unspecified site
- Adenoma › alpha-cell › pancreas
- Adenoma › alpha-cell › unspecified site
D35
Benign neoplasm of other and unspecified endocrine glands
Not billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027